Surgical stapling device

ABSTRACT

A surgical stapling device (10) includes a tool assembly (16, 116) that is mounted for articulation between a non-articulated position and articulated positions. In order to minimize wobbling of the tool assembly (16, 116) in the non-articulated position of the tool assembly (16, 116), the surgical stapling device (10) includes a mounting assembly (20, 120) that includes retention structure to retain the tool assembly (16, 116) in the non-articulated position until a predetermined force is applied to the tool assembly (16, 116).

FIELD

The technology is generally related to surgical stapling devices and, more particularly, to endoscopic surgical stapling devices with articulating tool assemblies.

BACKGROUND

Surgical stapling devices for performing surgical procedures endoscopically are well known and commonly used to minimize patient trauma and reduce patient recovery times. Typically, these stapling devices include an elongate body and a tool assembly that is supported on a distal end portion of the elongate body. In order to more easily access tissue within a body cavity during a surgical procedure, the tool assembly is pivotably secured to the elongate body for articulation between a non-articulated position in which the tool assembly is aligned with the elongate body to positions in which the tool assembly defines acute angles with the elongate body.

In known surgical stapling devices that include an articulating tool assembly, the tool assembly has a tendency to wobble when the tool assembly is in its non-articulated position and a force is applied to the tool assembly. That is, the tool assembly tends to move from its non-articulated position to positions in which the tool assembly is misaligned with the elongate body of the stapling device when a force is applied to the tool assembly. This tendency for the tool assembly to wobble causes difficulties for a clinician especially when the clinician is using the tool assembly to grasp and hold tissue steady during a surgical procedure.

SUMMARY

In aspects, this disclosure generally relates to an endoscopic surgical stapling device that includes a tool assembly that is mounted for articulation between a non-articulated position and articulated positions. In order to minimize wobbling of the tool assembly in the non-articulated position of the tool assembly, the stapling device includes a mounting assembly that includes retention structure to retain the tool assembly in the non-articulated position until a predetermined force is applied to the tool assembly.

One aspect of the disclosure is directed to a surgical stapling device that includes an elongate body, a tool assembly, and a mounting assembly. The elongate body defines a first longitudinal axis and has a proximal end portion and a distal end portion. The elongate body also includes an inner shaft that defines diametrically opposed recesses and an outer tube that is received about the inner shaft. Thea tool assembly defines a second longitudinal axis. The mounting assembly secured to the tool assembly and includes first and second hinges, a first mounting member, and a second mounting member. The first mounting member includes a body and a first hub that extends outwardly from the body of the first mounting member. The second mounting member includes a body and a second hub extending outwardly from the body of the second mounting member. Each of the first and second hinges includes a distal end portion and a proximal end portion. The distal end portion of the first hinge defines a bore the receives the first hub of the first mounting member and the distal end portion of the second hinge defines a second bore that receives the second hub of the second mounting member to pivotably secure the first and second hinges to the first and second mounting members. The proximal end portions of the first and second hinges are received within the diametrically opposed recesses of the inner shaft to fixedly secure the first and second hinges to the elongate body. The first and second hinges facilitate articulation of the first and second mounting members and the tool assembly in relation to the elongate body from a non-articulated position in which the first and second longitudinal axes are aligned to an articulated position in which the first and second longitudinal axes define an acute angle. The first and second mounting members each define a first engagement member and the first and second hinges each define a second engagement member, each of the first engagement members of the first and second mounting members receiving a respective second engagement member of the first and second hinges when the tool assembly is in the non-articulated position to retain the tool assembly in the non-articulated position.

In aspects of the disclosure, the stapling device includes a handle assembly that is coupled to the proximal end portion of the elongate body and includes a body defining a stationary handle and a movable handle supported on the body.

In some aspects of the disclosure, each of the first engagement members includes a concavity and each of the second engagement members defines a convexity.

In certain aspects of the disclosure, each of the first engagement members includes a protrusion and each of the second engagement members defines a bore.

In aspects of the disclosure, the first and second mounting members each include a cantilevered portion, wherein each of the protrusions is supported on a respective one of the cantilevered portions.

In some aspects of the disclosure, each of the proximal end portions of the first and second hinges defines a cutout and the diametrically opposed recesses in the inner shaft of the elongate body have a shape that corresponds to a shape of the proximal end portions of the first and second hinges to axially fix the first and second hinges to the elongate body.

In certain aspects of the disclosure, the outer tube of the elongate body is received about the inner shaft and is positioned over the diametrically opposed recesses to retain the proximal end portions of the first and second hinges within the recesses of the inner shaft.

In aspects of the disclosure, the tool assembly includes an anvil assembly and a cartridge assembly.

In some aspects of the disclosure, the anvil and cartridge assemblies have linear configurations.

In certain aspects of the disclosure, the handle assembly is coupled to the elongate body by a rotation knob that is rotatably secured to the body of the handle assembly such that rotation of the rotation knob in relation to the body of the handle assembly causes rotation of the tool assembly in relation to the body of the handle assembly.

In aspects of the disclosure, the rotation knob supports an articulation lever that is movable to move the tool assembly between the non-articulated position and the articulated positions.

In some aspects of the disclosure, the first mounting member is fixedly secured to the second mounting member to define a channel that extends through the mounting assembly.

In certain aspects of the disclosure, the channel converges from the proximal end of the channel to the distal end of the channel.

Other aspects of the disclosure are directed to a mounting assembly including first and second mounting members and first and second hinges. The first mounting member is fixedly coupled to the second mounting member to form a mounting assembly body that defines a channel that extends through the mounting assembly body. The first mounting member includes a body and a first hub extending outwardly from the body of the first mounting member. The second mounting member includes a body and a second hub extending outwardly from the body of the second mounting member. Each of the first and second hinges defines a longitudinal axis and includes a distal end portion and a proximal end portion. The distal end portion of the first hinge defines a bore that receives the first hub of the first mounting member and the distal end portion of the second hinge defines a second bore that receives the second hub of the second mounting member to pivotably secure the first and second hinges to the first and second mounting members. The proximal end portions of the first and second hinges are configured to fixedly engage a surgical stapling device. The first and second hinges facilitate articulation of the mount assembly body in relation to the first and second hinges from a non-articulated position in which the channel is aligned with the longitudinal axes of the first and second hinges to an articulated position in which the channel is misaligned with the longitudinal axes of the first and second hinges. The first and second mounting members each define a first engagement member and the first and second hinges each define a second engagement member. Each of the first engagement members of the first and second mounting members receive a respective second engagement member of the first and second hinges when the mounting assembly body is in the non-articulated position to retain the mount assembly body in the non-articulated position.

Other features of the disclosure will be appreciated from the following description.

BRIEF DESCRIPTION OF DRAWINGS

Various aspects of the disclosed surgical stapling device are described herein below with reference to the drawings, wherein:

FIG. 1 is a side perspective view of a surgical stapling device including exemplary aspects of the disclosure with a tool assembly supported on an elongate body of the stapling device;

FIG. 2 is an enlarged view of the indicated area of detail of the surgical stapling device shown in FIG. 1 ;

FIG. 3 is a side perspective cutaway view of a proximal end portion of the tool assembly and the distal end portion of the elongate body of the surgical stapling device shown in FIG. 1 with the tool assembly disengaged from the elongate body;

FIG. 4 is a side perspective exploded view of a mounting assembly of the surgical stapling device shown in FIG. 3 ;

FIG. 5 is a cross-sectional view taken along section line 5-5 of FIG. 2 ;

FIG. 6 is a side perspective view from the distal end of a distal portion of the surgical stapling device shown in FIG. 1 with the tool assembly in a slightly articulated position;

FIG. 7 is a cross-sectional view taken along section line 7-7 of FIG. 6 ;

FIG. 8 is a perspective view from above of the distal portion of the surgical stapling device shown in FIG. 6 with the tool assembly in a more articulated position;

FIG. 9 is an exploded perspective view of an alternative mounting assembly of the stapling device shown in FIG. 1 ; and

FIG. 10 FIG. 10 is a cross-sectional view taken along section line 5-5 of the surgical stapling shown in FIG. 1 with the mounting assembly shown in FIG. 9 .

DETAILED DESCRIPTION

The disclosed surgical stapling device will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. However, it is to be understood that the aspects of the disclosure are merely exemplary of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the disclosure in virtually any appropriately detailed structure. In addition, directional terms such as front, rear, upper, lower, top, bottom, distal, proximal, and similar terms are used to assist in understanding the description and are not intended to limit the disclosure.

In this description, the term “proximal” is used generally to refer to that portion of the device that is closer to a clinician, while the term “distal” is used generally to refer to that portion of the device that is farther from the clinician. In addition, the term “endoscopic” is used generally used to refer to endoscopic, laparoscopic, arthroscopic, and/or any other procedure conducted through a small diameter incision or cannula. Further, the term “clinician” is used generally to refer to medical personnel including doctors, nurses, and support personnel.

FIGS. 1 and 2 illustrate exemplary aspects of the disclosed surgical stapling device shown generally as stapling device 10. Stapling device 10 includes a handle assembly 12, an elongate body 14, and a tool assembly 16. The elongate body 14 defines a longitudinal axis “X” and includes a proximal end portion 14 a that is coupled to the handle assembly 12 and a distal end portion 14 b that supports the tool assembly 16. The tool assembly 16 includes a proximal end portion 16 a that is coupled to the elongate body 14 by a mounting assembly 20 that facilitates articulating movement of the tool assembly 16 in relation to the elongate body between a non-articulated position in which the an axis “Y” (FIG. 6 ) defined by the tool assembly 16 is aligned with the longitudinal axis “X” of the elongate body 14 and articulated positions in which the axis “Y” of the tool assembly 16 and the axis “X” of the elongate body 14 define an acute angles.

In aspects of the disclosure, the handle assembly 12 is manually operated and includes a stationary handle 24, a movable handle 26, retraction knobs 28, a rotation knob 30, and an articulation lever 32. The movable handle 26 is movable in relation to the stationary handle 24 to actuate the tool assembly 16, i.e., move the tool assembly 16 between open and clamped positions, eject staples, and cut tissue. The rotation knob 28 supports the elongate body 14 and is coupled to the handle assembly 12 for rotation such that rotation of the rotation knob 30 causes rotation of the elongate body 14 and the tool assembly 16 about the longitudinal axis “X” in relation to stationary portions of the handle assembly 12. The articulation lever 32 is coupled to the tool assembly 16 and can be manipulated to move the tool assembly 16 from its non-articulated position to its articulated positions. U.S. Pat. No. 6,241,139 (“‘139 Patent) and 7,424,965 (“‘965 Patent”) include detailed descriptions of exemplary components of the handle assembly 12 of the stapling device 10. Although the stapling device 10 is illustrated to have a manually operated handle assembly, it is envisioned that aspects of this disclosure are relevant to powered stapling devices including robotically controlled stapling devices. U.S. Pat. No. 9,055,943 discloses exemplary aspects of a powered stapling device.

The tool assembly 16 includes an anvil assembly 40 and a cartridge assembly 42. The anvil assembly 40 and the cartridge assembly 42 each have a linear configuration and include proximal ends 40 a, 42 a, respectively that are secured to the mounting assembly 20. In aspects of the disclosure, the anvil assembly 40 and the cartridge assembly 42 are mounted to the mounting assembly 20 by screws 46 that facilitate pivotal movement of the cartridge assembly 42 in relation to the anvil assembly 40 between open and clamped positions. As illustrated, the anvil assembly 40 is stationary in relation to the mounting assembly 20 and the cartridge assembly 42 pivots about the screws 46 towards and away from the anvil assembly 40. It is envisioned that the cartridge assembly 42 could be stationary in relation to the mounting assembly 20 and the anvil assembly 40 could pivot about the screws 46 towards and away from the cartridge assembly 42.

FIG. 3 illustrates the proximal end portion 16 a of the tool assembly 16 and the distal end portion of the elongate body 14 in spaced relation to each other with portions of the mounting assembly 20 secured to the tool assembly 16.

FIGS. 4 and 5 illustrate the mounting assembly 20 which includes a first mounting member 50, a second mounting member 52, a first hinge 54, and a second hinge 56. The first mounting member 50 includes a base portion 60 and a coupling portion 62. The base portion 60 of the first mounting portion 50 defines transverse bores 64 that receive the screws 46 (FIG. 2 ) to secure the base portion 60 of the first mounting member 50 to the proximal end portion 16 a of the tool assembly 16. The coupling portion 62 of the first mounting portion 50 includes a hub 66 that extends outwardly from an outer surface of the coupling portion 62 and defines an axis “Z” (FIG. 4 ) that is perpendicular to the longitudinal axis “Y” (FIG. 6 ) defined by the tool assembly 16. The coupling portion 62 also defines spaced bores 68 that are positioned outwardly of the hub 66 and extend in a direction parallel to the axis “Z” defined by the hub 66. An outer surface of the coupling portion 62 of the first mounting portion 50 defines a first engagement member including a dimple or concavity 69.

The second mounting member 52 also defines a hub 70 that extends outwardly from the outer surface of the second mounting member 52 and is coaxial with the hub 66 on the first mounting member 50. The second mounting member 52 includes two upwardly extending posts 72 (FIG. 4 ) that are received in the spaced bores 68 of the first mounting member 50 to secure the first mounting member 50 to the second mounting member 52 to define a mounting assembly body 53. When the first and second mounting members 50, 52, respectively are secured together, a channel 74 is defined through the mounting assembly body 53 that converges from a proximal end of the channel 74 towards a distal end of the channel 74. An outer surface of the second mounting portion 50 defines a second engagement member including a dimple or concavity 75 (FIG. 5 ).

The channel 74 receives a drive assembly (not shown) of the stapling device 10. The ‘139 Patent describes the construction and operation of an exemplary drive assembly of a surgical stapling device.

The first and second hinges 54, 56 are substantially linear and have distal end portions 80 and proximal end portions 82. Each of the distal end portions 80 of the first and second hinges 54, 56 defines a bore 86 and includes a dimple 88. Each of the bores 86 receives one of the hubs 66, 70 of a respective one of the first and second mounting members 50, 52. Each of the dimples 88 includes a convexity 90 (FIG. 5 ) on one side of the dimple 88. Each of the proximal end portions 82 of the first and second hinges 54, 56 is substantially rectangular in shape and defines at least one cutout 92. It is envisioned that the first and second hinges 54, 56 can have a variety of configurations. In some aspects of the disclosure, each of the first and second hinges 54, 56 includes a cutout 92 on each side of the hinge 54, 56. In aspects of the disclosure, the first and second hinges 54, 56 are formed from sheet metal although other materials of construction are envisioned.

FIG. 5A illustrates the distal end portion 14 b of the elongate body 14 and the proximal end portion 16 a of the tool assembly 16. The elongate body 14 includes an outer tube 100 and an inner shaft 102. The inner shaft 102 defines diametrically opposed recesses 104 that have a shape that corresponds to the shape of the proximal end portions 82 of the first and second hinges 54, 56. The proximal end portions 82 of the first and second hinges 54, 56 are received in the recesses 104 to axially fix the first and second hinge portions 54, 56 to the inner shaft 102 of the elongate body 14. The outer tube 100 of the elongate body 14 is positioned about the inner shaft 102 to prevent the first and second hinges 54, 56 from being removed from the recesses 104 of the of the inner shaft 102 to fixedly secure the first and second hinges 54, 56 to the elongate body 14.

When the first and second hinges 54, 56 are coupled to the mounting assembly 20, the bores 86 of the first and second hinges 54, 56 receive the hubs 66, 70 of the first and second mounting members 50, 52 to secure the distal end portion of the first and second hinges 54, 56 to opposite sides of the mounting assembly 20, and the proximal end portions 82 of the first and second hinge 54, 56 are received in the recesses 104 on opposite sides of the inner shaft 102 of the elongate body 14 to secure the proximal end portions of the first and second hinges 54, 56 to the distal end portion 14 b of the elongate body 14. The outer tube 100 of the elongate body 4 is positioned about the inner shaft 102 to maintain engagement of the first and second hinges 54, 56 with the elongate body 14.

FIGS. 5 and 5A illustrate the proximal end portion 16 a of the tool assembly 16 coupled to the distal end portion 14 b of the elongate body 14 with the tool assembly 16 in the non-articulated position. When the tool assembly 16 is in the non-articulated position, the convexities 90 of the dimples 88 on the first and second hinges 54, 56 are aligned with the concavities 69 in the first and second mounting members 50, 52 of the mounting assembly 20 to retain the tool assembly 16 in the non-articulated position until a predetermined force is applied to the tool assembly 16. This minimizes wobble of the tool assembly when the tool assembly 16 is in the non-articulated position. The amount of predetermined force can be selected by choosing the size or increasing the rigidity of the convexities 90 and/or the concavities 69. For example, increasing the size and or rigidity of the convexities 69 will increase the predetermined force required to move the tool assembly 16 from its non-articulated position. In the non-articulated position of the tool assembly, mounting assembly body 53 of the mounting assembly 20 is also in its non-articulated position in which the channel 74 of the mounting assembly body 53 is centrally located on the longitudinal axis “Y” of the tool assembly 16.

FIGS. 6-8 illustrate the tool assembly 16 as the tool assembly 16 is articulated in relation to the elongate body 14. When the tool assembly 16 is articulated in the direction of arrow “A” in FIGS. 6 and 8 about the axis “Z” defined by the hubs 66, 70 of the first and second mounting members 50, 52, the concavities 69 in the first and second mounting members 50, 52 are rotated out of alignment with the convexities 90 in the first and second hinges 54, 56.

FIGS. 9 and 10 illustrate an alternative mounting assembly shown generally as mounting assembly 120. The mounting assembly 120 is substantially similar to the mounting assembly 20 (FIG. 4 ) and includes first and second mounting members 150, 152 and first and second hinges 154, 156. The mounting assembly 120 differs from the mounting assembly 20 (FIG. 4 ) in that the convexities or dimples 88 on the first and second hinges 54 and 56 are replaced with bores 188 and the concavities 69 on the first and second mounting members 50, 52 are replaced with protuberances 169. The protuberances 169 are received within the bores 188 when the tool assembly 116 is in a non-articulated position to retain the tool assembly 116 in the non-articulated position and minimize wobble.

In some aspects of the disclosure, the protuberances 169 on each of the first and second mounting members 150, 152 are supported on cantilevered portions 180. The cantilevered portions 180 of the first and second mounting members 150, 152 are deformable inwardly to allow the protuberances to flex into and out of the bores 188 of the first and second hinges 154, 156.

Although the mounting assemblies 20 (FIG. 4 ) and 120 (FIG. 9 ) are shown to form part of a stapling device, it is envisioned that the mounting assemblies 20, 120 could also form part of a reload assembly or disposable loading unit (DLU) that is releasably coupled to the elongate body 14 of the stapling device 10. The ‘139 Patent discloses an exemplary reload/DLU.

Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary aspects of the disclosure. It is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another without departing from the scope of the present disclosure. As well, one skilled in the art will appreciate further features and advantages of the disclosure based on the above-described aspects of the disclosure. Accordingly, the disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. 

What is claimed is:
 1. A surgical stapling device comprising: an elongate body defining a first longitudinal axis and having a proximal end portion and a distal end portion, the elongate body including an inner shaft and an outer tube, the inner shaft defining diametrically opposed recesses; a tool assembly defining a second longitudinal axis; and a mounting assembly secured to the tool assembly, the mounting assembly including first and second hinges, a first mounting member, and a second mounting member, the first mounting member including a body and a first hub extending outwardly from the body of the first mounting member, the second mounting member including a body and a second hub extending outwardly from the body of the second mounting member, each of the first and second hinges including a distal end portion and a proximal end portion, the distal end portion of the first hinge defining a bore the receives the first hub of the first mounting member and the distal end portion of the second hinge defining a second bore that receives the second hub of the second mounting member to pivotably secure the first and second hinges to the first and second mounting members, the proximal end portions of the first and second hinges received within the diametrically opposed recesses of the inner shaft to fixedly secure the first and second hinges to the elongate body, wherein the first and second hinges facilitate articulation of the first and second mounting members and the tool assembly in relation to the elongate body from a non-articulated position in which the first and second longitudinal axes are aligned to an articulated position in which the first and second longitudinal axes define an acute angle; wherein the first and second mounting members each define a first engagement member and the first and second hinges each define a second engagement member, each of the first engagement members of the first and second mounting members receiving a respective second engagement member of the first and second hinges when the tool assembly is in the non-articulated position to retain the tool assembly in the non-articulated position.
 2. The surgical stapling device of claim 1, further including a handle assembly coupled to the proximal end portion of the elongate body, the handle assembly including a body defining a stationary handle and a movable handle supported on the body.
 3. The surgical stapling device of claim 1, wherein each of the first engagement members includes a concavity and each of the second engagement members defines a convexity.
 4. The surgical stapling device of claim 1, wherein each of the first engagement members includes a protrusion and each of the second engagement members defines a bore.
 5. The surgical stapling device of claim 4, wherein the first and second mounting members each include a cantilevered portion, each of the protrusions supported on a respective one of the cantilevered portions.
 6. The surgical stapling device of claim 1, wherein each of the proximal end portions of the first and second hinges defines a cutout and the diametrically opposed recesses in the inner shaft of the elongate body have a shape that corresponds to a shape of the proximal end portions of the first and second hinges to axially fix the first and second hinges to the elongate body.
 7. The surgical stapling device of claim 6, wherein the outer tube of the elongate body is received about the inner shaft and is positioned over the diametrically opposed recesses to retain the proximal end portions of the first and second hinges within the diametrically opposed recesses of the inner shaft.
 8. The surgical stapling device of claim 1, wherein the tool assembly includes an anvil assembly and a cartridge assembly.
 9. The surgical stapling device of claim 8, wherein the anvil and cartridge assemblies have linear configurations.
 10. The surgical stapling device of claim 2, wherein the handle assembly is coupled to the elongate body by a rotation knob, the rotation knob being rotatably secured to the body of the handle assembly such that rotation of the rotation knob in relation to the body of the handle assembly causes rotation of the tool assembly in relation to the body of the handle assembly.
 11. The surgical stapling device of claim 10, wherein the rotation knob supports an articulation lever, the articulation lever being movable to move the tool assembly between the non-articulated position and the articulated positions.
 12. The surgical stapling device of claim 1, wherein the first mounting member is fixedly secured to the second mounting member to define a channel that extends through the mounting assembly.
 13. The surgical stapling device of claim 12, wherein the channel converges from the proximal end of the channel to the distal end of the channel.
 14. A mounting assembly comprising: a first mounting member, and a second mounting member, the first mounting member fixedly coupled to the second mounting member to form a mounting assembly body, the mounting assembly body defining a channel that extends through the mounting assembly body, the first mounting member including a body and a first hub extending outwardly from the body of the first mounting member, the second mounting member including a body and a second hub extending outwardly from the body of the second mounting member: and a first hinge and a second hinge, each of the first and second hinges defining a longitudinal axis and including a distal end portion and a proximal end portion, the distal end portion of the first hinge defining a bore that receives the first hub of the first mounting member and the distal end portion of the second hinge defining a second bore that receives the second hub of the second mounting member to pivotably secure the first and second hinges to the first and second mounting members, the proximal end portions of the first and second hinges configured to fixedly engage a surgical stapling device, the first and second hinges facilitating articulation of the mount assembly body in relation to the first and second hinges from a non-articulated position in which the channel is aligned with the longitudinal axes of the first and second hinges and to an articulated position in which the channel is mis-aligned with the longitudinal axes of the first and second hinges; wherein the first and second mounting members each define a first engagement member and the first and second hinges each define a second engagement member, each of the first engagement members of the first and second mounting members receiving a respective second engagement member of the first and second hinges when the mounting assembly body is in the non-articulated position to retain the mount assembly body in the non-articulated position.
 15. The mounting assembly of claim 14, wherein each of the first engagement members includes a concavity and each of the second engagement members defines a convexity.
 16. The mounting assembly of claim 14, wherein each of the first engagement members includes a protrusion and each of the second engagement members defines a bore.
 17. The mounting assembly of claim 16, wherein the first and second mounting members each include a cantilevered portion, each of the protrusions supported on a respective one of the cantilevered portions.
 18. The mounting assembly of claim 14, wherein each of the proximal end portions of the first and second hinges defines a cutout and the recesses have a shape that corresponds to a shape of the proximal end portions of the first and second hinges to axially fix the first and second hinges to the elongate body. 